Penyakit Demam Tifoid
Penyakit Demam Tifoid (bahasa Inggris: Typhoid fever) yang biasa juga
disebut typhus atau types dalam bahasa Indonesianya, merupakan penyakit yang
disebabkan oleh bakteri Salmonella enterica, khususnya turunannya yaitu
Salmonella Typhi terutama menyerang bagian saluran pencernaan. Demam tifoid
adalah penyakit infeksi akut yang selalu ada di masyarakat (endemik) di
Indonesia, mulai dari usia balita, anak-anak dan dewasa.
Menurut keterangan dr. Arlin Algerina, SpA, dari RS Internasional Bintaro, Di Indonesia, diperkirakan antara 800 - 100.000 orang terkena penyakit tifus atau demam tifoid sepanjang tahun. Demam ini terutama muncul di musim kemarau dan konon anak perempuan lebih sering terserang, peningkatan kasus saat ini terjadi pada usia dibawah 5 tahun.
Menurut keterangan dr. Arlin Algerina, SpA, dari RS Internasional Bintaro, Di Indonesia, diperkirakan antara 800 - 100.000 orang terkena penyakit tifus atau demam tifoid sepanjang tahun. Demam ini terutama muncul di musim kemarau dan konon anak perempuan lebih sering terserang, peningkatan kasus saat ini terjadi pada usia dibawah 5 tahun.
Cara Penularan Penyakit Demam
Tifoid
Penyakit demam Tifoid ini bisa menyerang saat kuman tersebut masuk melalui makanan atau minuman, sehingga terjadi infeksi saluran pencernaan yaitu usus halus. Dan melalui peredaran darah, kuman sampai di organ tubuh terutama hati dan limpa. Ia kemudian berkembang biak dalam hati dan limpa yang menyebabkan rasa nyeri saat diraba.
Penyakit demam Tifoid ini bisa menyerang saat kuman tersebut masuk melalui makanan atau minuman, sehingga terjadi infeksi saluran pencernaan yaitu usus halus. Dan melalui peredaran darah, kuman sampai di organ tubuh terutama hati dan limpa. Ia kemudian berkembang biak dalam hati dan limpa yang menyebabkan rasa nyeri saat diraba.
Tanda dan Gejala Penyakit Demam
Tifoid
Penyakit ini bisa menyerang saat bakteri tersebut masuk melalui makanan atau minuman, sehingga terjadi infeksi saluran pencernaan yaitu usus halus. Kemudian mengikuti peredaran darah, bakteri ini mencapai hati dan limpa sehingga berkembang biak disana yang menyebabkan rasa nyeri saat diraba.
Gejala klinik demam tifoid pada anak biasanya memberikan gambaran klinis yang ringan bahkan dapat tanpa gejala (asimtomatik). Secara garis besar, tanda dan gejala yang ditimbulkan antara lain ;
Penyakit ini bisa menyerang saat bakteri tersebut masuk melalui makanan atau minuman, sehingga terjadi infeksi saluran pencernaan yaitu usus halus. Kemudian mengikuti peredaran darah, bakteri ini mencapai hati dan limpa sehingga berkembang biak disana yang menyebabkan rasa nyeri saat diraba.
Gejala klinik demam tifoid pada anak biasanya memberikan gambaran klinis yang ringan bahkan dapat tanpa gejala (asimtomatik). Secara garis besar, tanda dan gejala yang ditimbulkan antara lain ;
- Demam lebih dari seminggu. Siang
hari biasanya terlihat segar namun menjelang malamnya demam tinggi.
- Lidah kotor. Bagian tengah
berwarna putih dan pinggirnya merah. Biasanya anak akan merasa lidahnya
pahit dan cenderung ingin makan yang asam-asam atau pedas.
- Mual Berat sampai muntah.
Bakteri Salmonella typhi berkembang biak di hatidan limpa, Akibatnya
terjadi pembengkakan dan akhirnya menekan lambung sehingga terjadi rasa
mual. Dikarenakan mual yang berlebihan, akhirnya makanan tak bisa masuk
secara sempurna dan biasanya keluar lagi lewat mulut.
- Diare atau Mencret. Sifat
bakteri yang menyerang saluran cerna menyebabkan gangguan penyerapan
cairan yang akhirnya terjadi diare, namun dalam beberapa kasus justru
terjadi konstipasi (sulit buang air besar).
- Lemas, pusing, dan sakit perut.
Demam yang tinggi menimbulkan rasa lemas, pusing. Terjadinya pembengkakan
hati dan limpa menimbulkan rasa sakit di perut.
- Pingsan, Tak sadarkan diri.
Penderita umumnya lebih merasakan nyaman dengan berbaring tanpa banyak
pergerakan, namun dengan kondisi yang parah seringkali terjadi gangguan
kesadaran.
Diagnosa Penyakit Demam Tifoid
Untuk ke akuratan dalam penegakan diagnosa penyakit, dokter akan melakukan beberapa pemeriksaan laboratorium diantaranya pemeriksaan darah tepi, pemeriksaan Widal dan biakan empedu.
Untuk ke akuratan dalam penegakan diagnosa penyakit, dokter akan melakukan beberapa pemeriksaan laboratorium diantaranya pemeriksaan darah tepi, pemeriksaan Widal dan biakan empedu.
- Pemeriksaan darah tepi merupakan
pemeriksaan sederhana yang mudah dilakukan di laboratorium sederhana untuk
membuat diagnosa cepat. Akan ada gambaran jumlah darah putih yang
berkurang (lekopenia), jumlah limfosis yang meningkat dan eosinofilia.
- Pemeriksaan Widal adalah
pemeriksaan darah untuk menemukan zat anti terhadap kuman tifus. Widal
positif kalau titer O 1/200 atau lebih dan atau menunjukkan kenaikan
progresif.
- Diagnosa demam Tifoid pasti
positif bila dilakukan biakan empedu dengan ditemukannya kuman Salmonella
typhosa dalam darah waktu minggu pertama dan kemudian sering ditemukan
dalam urine dan faeces.
Sampel darah yang positif dibuat untuk menegakkan diagnosa pasti. Sample urine dan faeces dua kali berturut-turut digunakan untuk menentukan bahwa penderita telah benar-benar sembuh dan bukan pembawa kuman (carrier).
Sedangkan untuk memastikan apakah penyakit yang diderita pasien adalah penyakit lain maka perlu ada diagnosa banding. Bila terdapat demam lebih dari lima hari, dokter akan memikirkan kemungkinan selain demam tifoid yaitu penyakit infeksi lain seperti Paratifoid A, B dan C, demam berdarah (Dengue fever), influenza, malaria, TBC (Tuberculosis), dan infeksi paru (Pneumonia).
Perawatan dan Pengobatan Penyakit
Demam Tifoid
Perawatan dan pengobatan terhadap penderita penyakit demam Tifoid atau types bertujuan menghentikan invasi kuman, memperpendek perjalanan penyakit, mencegah terjadinya komplikasi, serta mencegah agar tak kambuh kembali. Pengobatan penyakit tifus dilakukan dengan jalan mengisolasi penderita dan melakukan desinfeksi pakaian, faeces dan urine untuk mencegah penularan. Pasien harus berbaring di tempat tidur selama tiga hari hingga panas turun, kemudian baru boleh duduk, berdiri dan berjalan.
Selain obat-obatan yang diberikan untuk mengurangi gejala yang timbul seperti demam dan rasa pusing (Paracetamol), Untuk anak dengan demam tifoid maka pilihan antibiotika yang utama adalah kloramfenikol selama 10 hari dan diharapkan terjadi pemberantasan/eradikasi kuman serta waktu perawatan dipersingkat. Namun beberapa dokter ada yang memilih obat antibiotika lain sepertiampicillin, trimethoprim-sulfamethoxazole, kotrimoksazol, sefalosporin, dan ciprofloxacin sesuai kondisi pasien. Demam berlebihan menyebabkan penderita harus dirawat dan diberikan cairan Infus.
Perawatan dan pengobatan terhadap penderita penyakit demam Tifoid atau types bertujuan menghentikan invasi kuman, memperpendek perjalanan penyakit, mencegah terjadinya komplikasi, serta mencegah agar tak kambuh kembali. Pengobatan penyakit tifus dilakukan dengan jalan mengisolasi penderita dan melakukan desinfeksi pakaian, faeces dan urine untuk mencegah penularan. Pasien harus berbaring di tempat tidur selama tiga hari hingga panas turun, kemudian baru boleh duduk, berdiri dan berjalan.
Selain obat-obatan yang diberikan untuk mengurangi gejala yang timbul seperti demam dan rasa pusing (Paracetamol), Untuk anak dengan demam tifoid maka pilihan antibiotika yang utama adalah kloramfenikol selama 10 hari dan diharapkan terjadi pemberantasan/eradikasi kuman serta waktu perawatan dipersingkat. Namun beberapa dokter ada yang memilih obat antibiotika lain sepertiampicillin, trimethoprim-sulfamethoxazole, kotrimoksazol, sefalosporin, dan ciprofloxacin sesuai kondisi pasien. Demam berlebihan menyebabkan penderita harus dirawat dan diberikan cairan Infus.
Komplikasi Penyakit Demam Tifoid
Komplikasi yang sering dijumpai pada anak penderita penyakit demam tifoid adalah perdarahan usus karena perforasi, infeksi kantong empedu (kolesistitis), dan hepatitis. Gangguan otak (ensefalopati) kadang ditemukan juga pada anak.
Komplikasi yang sering dijumpai pada anak penderita penyakit demam tifoid adalah perdarahan usus karena perforasi, infeksi kantong empedu (kolesistitis), dan hepatitis. Gangguan otak (ensefalopati) kadang ditemukan juga pada anak.
Diet Penyakit Demam Tifoid
Penderita penyakit demam Tifoid selama menjalani perawatan haruslah mengikuti petunjuk diet yang dianjurkan oleh dokter untuk di konsumsi, antara lain :
Penderita penyakit demam Tifoid selama menjalani perawatan haruslah mengikuti petunjuk diet yang dianjurkan oleh dokter untuk di konsumsi, antara lain :
- Makanan yang cukup cairan, kalori,
vitamin & protein.
- Tidak mengandung banyak serat.
- Tidak merangsang dan tidak
menimbulkan banyak gas.
- Makanan lunak diberikan selama
istirahat.
Untuk kembali ke makanan "normal", lakukan secara bertahap
bersamaan dengan mobilisasi. Misalnya hari pertama dan kedua makanan lunak,
hari ke-3 makanan biasa, dan seterusnya.
Pencegahan Penyakit Demam Tifoid
Pencegahan penyakit demam Tifoid bisa dilakukan dengan cara perbaikan higiene dan sanitasi lingkungan serta penyuluhan kesehatan. Imunisasi dengan menggunakan vaksin oral dan vaksin suntikan (antigen Vi Polysaccharida capular) telah banyak digunakan. Saat ini pencegahan terhadap kuman Salmonella sudah bisa dilakukan dengan vaksinasi bernama chotipa (cholera-tifoid-paratifoid) atau tipa (tifoid-paratifoid). Untuk anak usia 2 tahun yang masih rentan, bisa juga divaksinasi.
Typhoid Fever diseaseTyphoid Fever disease (English: Typhoid fever) is usually called typhus or types in the Indonesian language, is a disease caused by the bacterium Salmonella enterica, Salmonella Typhi in particular derivatives which primarily affects the digestive tract.Typhoid fever is an acute infectious disease that always exist in society (endemic) in Indonesia, ranging in age from toddlers, children and adults.According to dr. Arlin Algerina, SpA, of International Hospital Bintaro, in Indonesia, estimated between 800 - 100,000 people were exposed to typhus or typhoid fever throughout the year. This fever occurs mainly in the dry season and said girls are more often affected, the current increase in cases occurred at ages under 5 years old.
How Typhoid Fever Disease TransmissionTyphoid fever can strike when the bacteria enter through food or water, resulting in infection of the digestive tract is the small intestine. And through the bloodstream, the bacteria reach the organs especially the liver and spleen. He then proliferate in the liver and spleen that causes pain when touched.
Signs and Symptoms of Typhoid FeverThis disease can strike when the bacteria enter through food or water, resulting in infection of the digestive tract is the small intestine. Then follow the bloodstream, the bacteria reach the liver and spleen that proliferate there that causes pain when touched.Clinical symptoms of typhoid fever in children usually give a mild clinical picture can be even without symptoms (asymptomatic). Broadly speaking, the signs and symptoms are caused, among others;Fever more than a week. Daytime looks fresh but usually a high fever the night before.Dirty tongue. The center of the white and red edges. Usually the child will feel bitter tongue and tend to eat a fatty acid or spicy.Weight nausea to vomiting. Salmonella typhi bacteria multiply in the spleen hatidan, result in swelling and eventually suppress the stomach, causing nausea. Due to excessive nausea, eventually enter the food can not be perfect, and usually come out again through the mouth.Diarrhea or Diarrhoea. Properties of the bacteria that attacks the gastrointestinal absorption of fluids cause diarrhea which finally took place, but in some cases actually occurred constipation (hard bowel movements).Weakness, dizziness, and abdominal pain. A high fever cause weakness, dizziness.Swelling of the liver and spleen causing pain in the abdomen.Unconscious, not conscious. Patients generally feel more comfortable with lying without much movement, but with a severe condition often occurs impaired consciousness. Diagnosis of Typhoid FeverFor the accuracy of disease diagnosis in the enforcement of, the doctor will perform some laboratory tests including peripheral blood examination, examination of Widal and bile culture.Examination of peripheral blood is a simple examination that is easily done in a simple laboratory to make a quick diagnosis. There will be a picture of a reduced white blood count (leukopenia), increased the number limfosis and eosinophilia.Widal examinations are blood tests to find an anti-typhoid germ. If a positive Widal O titers 1/200 or more and or show a progressive increase.Typhoid fever positive definite diagnosis when performed by the finding of bile cultures of Salmonella typhosa bacteria in the blood of the first week and then often found in the urine and faeces.Positive blood samples for diagnosis must be made. Urine and faeces samples twice in a row is used to determine that the patient has completely recovered and not the germ carrier (carrier).While to ascertain whether the patient's illness is another disease it is necessary to diagnosis. If there is a fever of more than five days, the doctor will think about the possibility of typhoid fever in addition to other infectious diseases such as paratyphoid A, B and C, dengue fever (Dengue fever), influenza, malaria, tuberculosis (TB), and lung infection (pneumonia).
Care and Treatment of Typhoid Fever DiseaseCare and treatment of patients with typhoid fever illnesses or types aimed at stopping the invasion of bacteria, shortening the course of the disease, prevent complications, and did not prevent recurrence. Treatment of typhoid was done by isolating the patient and conduct disinfection of clothing, faeces and urine to prevent transmission. The patient must lie in bed for three days until the heat down, and then be sitting, standing and walking.In addition to the drugs given to relieve symptoms such as fever and dizziness (Paracetamol), For children with typhoid fever is a major choice is chloramphenicol antibiotic for 10 days and is expected to occur eradication / eradication of the bacteria as well as the treatment time is shortened. But there are some doctors who choose sepertiampicillin other antibiotics, trimethoprim-sulfamethoxazole, cotrimoxazole, cephalosporins, and ciprofloxacin according to the patient's condition. Excessive fever causing the patient to be admitted and given fluid infusion.
Complications of Typhoid Fever DiseaseA common complication in children with typhoid fever is intestinal bleeding due to perforation, infection of the gallbladder (cholecystitis), and hepatitis. Disorders of the brain (encephalopathy) are occasionally found also in children.
Diet Diseases Typhoid FeverTyphoid fever disease patients during treatment should follow the diet recommended by doctors for consumption, among others:Foods that are quite fluid, calories, vitamins and protein.Does not contain much fiber.Not stimulate and does not cause a lot of gas.Food is provided during the break.To return to the food "normal", do it gradually along with the mobilization. For example, first and second days of soft food, day-to-3 regular meals, and so on.
Prevention of Typhoid Fever DiseasePrevention of Typhoid fever can be done by way of improved hygiene and environmental sanitation and health education. Immunization with oral vaccines and vaccine injections (Vi antigen polysaccharida capular) has been widely used. Currently the prevention of Salmonella bacteria can be done with named chotipa vaccination (cholera, typhoid, paratyphoid) or TIPA (typhoid, paratyphoid). For children aged 2 years who are still vulnerable, it could also be vaccinated.
Pencegahan penyakit demam Tifoid bisa dilakukan dengan cara perbaikan higiene dan sanitasi lingkungan serta penyuluhan kesehatan. Imunisasi dengan menggunakan vaksin oral dan vaksin suntikan (antigen Vi Polysaccharida capular) telah banyak digunakan. Saat ini pencegahan terhadap kuman Salmonella sudah bisa dilakukan dengan vaksinasi bernama chotipa (cholera-tifoid-paratifoid) atau tipa (tifoid-paratifoid). Untuk anak usia 2 tahun yang masih rentan, bisa juga divaksinasi.
Typhoid Fever diseaseTyphoid Fever disease (English: Typhoid fever) is usually called typhus or types in the Indonesian language, is a disease caused by the bacterium Salmonella enterica, Salmonella Typhi in particular derivatives which primarily affects the digestive tract.Typhoid fever is an acute infectious disease that always exist in society (endemic) in Indonesia, ranging in age from toddlers, children and adults.According to dr. Arlin Algerina, SpA, of International Hospital Bintaro, in Indonesia, estimated between 800 - 100,000 people were exposed to typhus or typhoid fever throughout the year. This fever occurs mainly in the dry season and said girls are more often affected, the current increase in cases occurred at ages under 5 years old.
How Typhoid Fever Disease TransmissionTyphoid fever can strike when the bacteria enter through food or water, resulting in infection of the digestive tract is the small intestine. And through the bloodstream, the bacteria reach the organs especially the liver and spleen. He then proliferate in the liver and spleen that causes pain when touched.
Signs and Symptoms of Typhoid FeverThis disease can strike when the bacteria enter through food or water, resulting in infection of the digestive tract is the small intestine. Then follow the bloodstream, the bacteria reach the liver and spleen that proliferate there that causes pain when touched.Clinical symptoms of typhoid fever in children usually give a mild clinical picture can be even without symptoms (asymptomatic). Broadly speaking, the signs and symptoms are caused, among others;Fever more than a week. Daytime looks fresh but usually a high fever the night before.Dirty tongue. The center of the white and red edges. Usually the child will feel bitter tongue and tend to eat a fatty acid or spicy.Weight nausea to vomiting. Salmonella typhi bacteria multiply in the spleen hatidan, result in swelling and eventually suppress the stomach, causing nausea. Due to excessive nausea, eventually enter the food can not be perfect, and usually come out again through the mouth.Diarrhea or Diarrhoea. Properties of the bacteria that attacks the gastrointestinal absorption of fluids cause diarrhea which finally took place, but in some cases actually occurred constipation (hard bowel movements).Weakness, dizziness, and abdominal pain. A high fever cause weakness, dizziness.Swelling of the liver and spleen causing pain in the abdomen.Unconscious, not conscious. Patients generally feel more comfortable with lying without much movement, but with a severe condition often occurs impaired consciousness. Diagnosis of Typhoid FeverFor the accuracy of disease diagnosis in the enforcement of, the doctor will perform some laboratory tests including peripheral blood examination, examination of Widal and bile culture.Examination of peripheral blood is a simple examination that is easily done in a simple laboratory to make a quick diagnosis. There will be a picture of a reduced white blood count (leukopenia), increased the number limfosis and eosinophilia.Widal examinations are blood tests to find an anti-typhoid germ. If a positive Widal O titers 1/200 or more and or show a progressive increase.Typhoid fever positive definite diagnosis when performed by the finding of bile cultures of Salmonella typhosa bacteria in the blood of the first week and then often found in the urine and faeces.Positive blood samples for diagnosis must be made. Urine and faeces samples twice in a row is used to determine that the patient has completely recovered and not the germ carrier (carrier).While to ascertain whether the patient's illness is another disease it is necessary to diagnosis. If there is a fever of more than five days, the doctor will think about the possibility of typhoid fever in addition to other infectious diseases such as paratyphoid A, B and C, dengue fever (Dengue fever), influenza, malaria, tuberculosis (TB), and lung infection (pneumonia).
Care and Treatment of Typhoid Fever DiseaseCare and treatment of patients with typhoid fever illnesses or types aimed at stopping the invasion of bacteria, shortening the course of the disease, prevent complications, and did not prevent recurrence. Treatment of typhoid was done by isolating the patient and conduct disinfection of clothing, faeces and urine to prevent transmission. The patient must lie in bed for three days until the heat down, and then be sitting, standing and walking.In addition to the drugs given to relieve symptoms such as fever and dizziness (Paracetamol), For children with typhoid fever is a major choice is chloramphenicol antibiotic for 10 days and is expected to occur eradication / eradication of the bacteria as well as the treatment time is shortened. But there are some doctors who choose sepertiampicillin other antibiotics, trimethoprim-sulfamethoxazole, cotrimoxazole, cephalosporins, and ciprofloxacin according to the patient's condition. Excessive fever causing the patient to be admitted and given fluid infusion.
Complications of Typhoid Fever DiseaseA common complication in children with typhoid fever is intestinal bleeding due to perforation, infection of the gallbladder (cholecystitis), and hepatitis. Disorders of the brain (encephalopathy) are occasionally found also in children.
Diet Diseases Typhoid FeverTyphoid fever disease patients during treatment should follow the diet recommended by doctors for consumption, among others:Foods that are quite fluid, calories, vitamins and protein.Does not contain much fiber.Not stimulate and does not cause a lot of gas.Food is provided during the break.To return to the food "normal", do it gradually along with the mobilization. For example, first and second days of soft food, day-to-3 regular meals, and so on.
Prevention of Typhoid Fever DiseasePrevention of Typhoid fever can be done by way of improved hygiene and environmental sanitation and health education. Immunization with oral vaccines and vaccine injections (Vi antigen polysaccharida capular) has been widely used. Currently the prevention of Salmonella bacteria can be done with named chotipa vaccination (cholera, typhoid, paratyphoid) or TIPA (typhoid, paratyphoid). For children aged 2 years who are still vulnerable, it could also be vaccinated.
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